INTRODUCTION Objective assessment of final REBOA position and adequate distal aortic occlusion is critical in patients with hemorrhagic shock, especially as feasibility is being increasingly investigated in the pre-hospital setting. We propose that mobile forward looking infrared (FLIR) thermal imaging is a fast, reliable, and non-invasive method to assess REBOA position and efficacy in scenarios applicable to battlefield and pre-hospital care. METHODS Ten swine were randomized to a 40% hemorrhage group (H, n=5) or non-hemorrhage group (NH, n=5). Three experiments were completed after zone one placement of a REBOA catheter. REBOA was deployed for 30 minutes in all animals followed by randomized continued deployment vs sham in both light and blackout conditions. FLIR images and hemodynamic data were obtained. Images were presented to 62 blinded observers for assessment of REBOA inflation status. RESULTS There was no difference in hemodynamic or laboratory values at baseline. The H group was significantly more hypotensive (MAP 44 vs 60, p
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